Individual provider Active NPI

Courtney Deanna Gehrer, LCSW

  • Clinical Social Worker
  • Clayton, MO
National Provider Identifier
1033649470
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2021049315 Issued in MO
Practice address
100 S Central Ave
Clayton, MO 63105-1709
Phone
(314) 615-8773
NPI assigned
Jun 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2021049315 MO Primary

Addresses

Primary practice location

100 S Central Ave
Clayton, MO 63105-1709

Mailing address

6121 N Hanley Rd
Berkeley, MO 63134-2003

Other identifiers 1

IdentifierTypeStateIssuer
2021049315OtherMOLCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021049315MOMDClinical Social Worker
56958TXMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1033649470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 N HANLEY RD",
            "city": "BERKELEY",
            "state": "MO",
            "postal_code": "631342003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S CENTRAL AVE",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631051709",
            "telephone_number": "314-615-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHRER",
        "first_name": "COURTNEY",
        "middle_name": "DEANNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2021049315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "2021049315",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.